HEALTH CARE
Wednesday, March 15, 2017
East Oregonian
Page 7A
AP FACT CHECK
Both sides loose with facts in health debate
By CALVIN WOODWARD and
RICARDO ALONSO-ZALDIVAR
Associated Press
WASHINGTON
—
The
Congressional Budget Office report
on a Republican health care bill set
off an intense reaction in Wash-
ington, and some on both sides of
the debate are playing loose with
the facts.
Republicans are overlooking
President Donald Trump’s promise
to deliver “insurance for every-
body,” which the CBO makes clear
will not happen if the legislation
becomes law. Democrats are
assailing Republicans for “attacking
the messenger,” seeming to forget
all the times they assailed the budget
office themselves.
The Congressional Budget
Office is respected for nonpartisan
rigor in its estimates of the costs
and impacts of legislation. But no
projection is infallible, particularly
when it comes to large, complex
programs. For example, the agency
in 2010 overstated the number of
people expected to buy insurance
under President Barack Obama’s
health care law, misjudging how
many would join because of the
threat of tax penalties.
Yet, CBO’s neutrality has been
valued by both parties — though not
always at the same time. It depends
whose ox is being gored.
A look at statements in the debate
and how they compare with the
CBO’s estimates and the underlying
facts:
TRUMP: “We’re going to have
insurance for everybody. There was
a philosophy in some circles that if
you can’t pay for it, you don’t get it.
That’s not going to happen with us.”
— To The Washington Post, Jan. 15.
CBO: It estimates the bill would
leave 14 million fewer people
insured in the first year, 24 million
fewer by 2026.
In the first year, the biggest
reason more people are uninsured
would be repeal of penalties Barack
Obama’s law imposes on those
deemed able to afford insurance but
who don’t buy it. Still others would
decide to forgo coverage because
of higher premiums or do without
Medicaid.
In following years the main
AP Photo/Pablo Martinez Monsivais
White House Press secretary Sean Spicer speaks to the media
during the daily briefing in the Brady Press Briefing Room of the
White House in Washington, Tuesday.
reason for a drop in the number of
insured would be that the Repub-
lican bill scales back Medicaid for
low-income Americans. Altogether,
CBO estimates 52 million people
would be uninsured by 2026, a
vast distance from “insurance for
everybody.”
———
SEAN SPICER, White House
press secretary, Tuesday: “Having a
card and having coverage that when
you walk into a doctor’s office has
a deductible of $15,000, $20,000
a year isn’t coverage. That’s a car.
That doesn’t get you the care you
need.”
THE FACTS: He’s wrong about
deductibles under Obama’s law.
Out-of-pocket expenses for
consumers are limited. Deduct-
ibles, copayments, and coinsurance
together can’t exceed $7,150 this
year for an individual plan sold
through HealthCare.gov or similar
state markets. For a family plan it’s
$14,300. After that, the insurance
plan pays the full cost of covered
benefits.
In addition, more than half of
customers in these plans get subsi-
dies to help with their out-of-pocket
costs.
———
SEN. CHUCK SCHUMER,
Senate Democratic leader: “CBO
is virtually unassailable. Everyone,
Democrats
and
Republicans,
whether it be George Bush, Barack
Obama or anyone else has gone
along with CBO. ...CBO speaks
the truth. They’ve been speaking
the truth for decades and to try to
attack CBO is simply attacking
the messenger.” — Comments to
reporters Monday.
REP. NANCY PELOSI, House
Democratic leader, on Republican
reaction to the CBO: “Some of
them are trying to pin a rose on this
report and make it sound like it’s a
good thing and the others of them
are trying to discredit the CBO, but
it’s completely wrong, completely
wrong. ... Numbers are quite elegant
things, you know. They speak very
clearly.” — Comments to reporters
Monday.
THE FACTS: Democrats
have not hesitated to attack this
messenger when its conclusions
have not suited them.
“The Congressional Budget
Office never gives us any credit,”
President Obama said in 2009 when
the CBO pointed to the expense
of Democratic health overhaul
proposals. Complained Pelosi at the
time: “The CBO will always give
you the worst-case scenario.”
Again in 2014, Pelosi did not
consider CBO’s numbers “elegant,”
or correct, when they forecast job
losses from a Democratic effort
to raise the minimum wage. She
accused the CBO of making argu-
ments that “contradict the consensus
among hundreds of America’s top
economists” and said it “ignored
new perspectives in the wide array
of analysis on the minimum wage.”
———
TRUMP: People covered
under the law “can expect to have
great health care. It will be in a
much simplified form. Much less
expensive and much better... lower
numbers, much lower deductibles.”
CBO: It says cost-sharing
payments in the individual market,
including deductibles, “would tend
to be higher than those anticipated
under current law.” Cost-sharing
subsidies would be repealed in
2020, “significantly increasing
out-of-pocket costs for nongroup
(private) insurance for many
lower-income enrollees.”
———
TRUMP, at a Cabinet meeting
Monday: “Obamacare, all of a
sudden, the last couple of weeks,
is getting a false rep that maybe it’s
OK. It’s not OK, it’s a disaster and
people understand that it’s failed
and it’s imploding. And if we let
it go for another year, it’ll totally
implode.”
CBO: Not in the view of the
budget experts. They described
the market for individual policies
under Obama’s health care law as
“stable.” They said it is likely to
remain stable under the proposed
GOP replacement legislation, too.
———
MICK MULVANEY, Trump’s
budget director: “If you have
coverage that doesn’t allow you
to go to the doctor, what good is it
in the first place? Democrats took
all of this credit for giving people
coverage, but ignored the fact that
they had created this large group of
people that still could not go to the
doctor.” — Tuesday on MSNBC’s
“Morning Joe.”
THE FACTS: Republicans
gloss over reality when they make
this argument. While deductibles are
high for the Affordable Care Act’s
private insurance plans (averaging
$3,000 last year for a standard silver
plan), the law requires preventive
care to be covered at no charge.
And more than half of the people
enrolled in the health law’s insur-
ance markets get an extra subsidy
when they go to seek care. It can
reduce a deductible from several
thousand dollars to a few hundred.
The GOP bill would repeal those
subsidies.
Other evidence points to
tangible benefits from Obama’s
coverage expansion. For example,
government researchers have found
fewer Americans struggling to pay
medical bills. A 2015 report found
that problems with medical bills
had declined for the fourth year in
a row. Most of the improvement
was among low-income people and
those with government coverage,
and it coincided with the ACA’s big
coverage expansion.
———
TOM PRICE, health and
human services secretary: “I firmly
believe that nobody will be worse
off financially in the process that
we’re going through.” — NBC’s
“Meet the Press,” Sunday.
CBO: There are losers as well
as winners, the analysts found.
Generally, older people are bound
to face higher costs because the
legislation would let insurance
companies charge them up to five
times more for premiums than they
charge young people. They can only
be charged three times more now.
The bottom line, the analysts say,
would be “substantially reducing
premiums for young adults and
substantially raising premiums for
older people.”
———
MULVANEY: “Actually I don’t
think the costs will go up at all.” —
ABC’s “This Week,” Sunday.
CBO: It estimates that some
costs indeed will go up, at least
for a few years. The analysts say
average premiums in the private
insurance market would rise in
2018 and 2019 by 15 percent to 20
percent, compared with current law,
then start to come down. By 2026,
average premiums could be 10
percent lower, compared with the
existing law. One reason: insurers
could eliminate a current require-
ment to offer plans that cover a set
percentage of the cost of certain
benefits.
Defiant conservatives still fighting Trump’s health bill
WASHINGTON
(AP)
— Undaunted by fellow
Republicans’
defiance,
GOP leaders and the White
House redoubled their efforts
Tuesday to muscle legislation
overhauling America’s health
care system through Congress
following a sobering report
about millions being shoved
off insurance coverage.
President Donald Trump,
whose strong Election Day
showing in GOP regions
makes him the party’s ulti-
mate Capitol Hill vote wran-
gler, discussed the legislation
by phone with the House’s
two top Republicans. He also
dispatched Vice President
Mike Pence and health secre-
tary Tom Price to hear GOP
senators’ concerns.
With leaders hoping to
move the measure through
the House next week so the
Senate can debate it, changes
in the measure seemed all but
certain. Trump’s spokesman
acknowledged they were open
to revisions to win support.
“This has never been a
take it or leave it,” said Press
Secretary Sean Spicer.
The GOP bill is the party’s
response to seven years of
promising to repeal President
Barack Obama’s 2010 health
care overhaul. It would undo
that law’s individual mandate,
which requires most people
to have coverage, by ending
the tax penalty on those who
don’t.
It would also provide
age-based tax credits instead
of the subsidies geared to
income in Obama’s statute,
end that law’s expansion of
Medicaid and curb its future
spending, and let insurers
boost rates for seniors.
On Monday, the Congres-
sional Budget Office said the
Republican legislation would
reduce the ranks of the insured
by 24 million in a decade,
largely by cutting Medicaid
recipients and people buying
individual policies. That
would be more than the
20 million who’ve gained
coverage under Obama’s
overhaul — and attach a big
number to a problem haunting
GOP governors and members
of Congress whose states have
benefited from “Obamacare.”
“I plan to vote NO” on
AP Photo/J. Scott Applewhite
Senate Majority Leader Mitch McConnell, R-Ky., joined
by, from left, Sen. John Barrasso, R-Wyo., Sen. Roy
Blunt, R-Mo., and Majority Whip John Cornyn, R-Texas,
speaks with reporters at the Capitol, Tuesday.
the GOP bill, Rep. Ileana
Ros-Lehtinen, R-Fla., tweeted
Tuesday. “As written the
plan leaves too many from
my (hash)SoFla district unin-
sured.”
The budget office report
also said the measure would
reduce federal deficits by $337
billion over the next decade,
largely by cutting Medicaid,
the health insurance program
for the poor, and eliminating
Obama’s subsidies for low-
and middle-income people.
The report said that the bill’s
changes would result in
federal subsidies that would
fall to half their current size in
a decade and that older, lower-
earning people would be hit
especially hard.
Those findings further
energized Democrats, who
already were unanimously
opposing the GOP repeal
effort and showing no sign of
relenting.
“Of course you can have
savings if you cut off millions
of people from access to health
care,” said House Minority
Leader Nancy Pelosi of Cali-
fornia. She said the measure’s
shift of billions of dollars from
lower- to higher-earning fami-
lies actually would effectively
transfer money from GOP
to Democratic regions, and,
seemingly taunting Republi-
cans, she added, “Explain that
to your constituents.”
Pence and Price discussed
the legislation over lunch
with GOP senators at the
Capitol. Participants said
senators suggested targeting
the bill’s new tax credits
more at lower-earning people,
improving benefits for seniors
and protecting the expansion
of Medicaid, the federal-state
program that helps lower-in-
come people afford care.
Senate Majority Leader
Mitch McConnell, R-Ky.,
all but acknowledged the
widespread assumption that
the measure will be reshaped,
saying, “It will be open to
amendment in the Senate.”
Emerging from the senators’
lunch — which included two
House committee chairmen
as well as Pence and Price
— Sen. Pat Roberts, R-Kan.,
said, “All four of them are
open to suggestions and
change.”
Even
so,
criticism
cascaded from both ends of
the GOP political continuum,
suggesting leaders face a
festering problem.
Conservatives continued
complaining the Republican
measure doesn’t fully repeal
Obama’s law, as they and
Trump promised in last fall’s
election campaigns. Their
demands include voiding
the law’s requirement that
policies cover 10 specified
benefits like mental health
services, which they say
drives up consumers’ costs.
“Ultimately it will be
President Trump that saves
this deal,” said Rep. Mark
Meadows, R-N.C., head of
the hard-line conservative
House Freedom Caucus.
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